A provision in health care legislation before Congress would require large chain restaurants to add nutrition labels, as on this McDonald's Egg McMuffin in California.

Sen. Jeff Merkley, D-Ore.

AP

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By John Fritze, USA TODAY

WASHINGTON  The health care bills moving through Congress would do a lot more than revamp the nation's $2.6 trillion health care system.

Buried among proposed programs for the uninsured are dozens of lesser-known provisions — from work breaks for breastfeeding moms to a requirement that chain restaurants disclose how many calories are in the fries.

Many of the ideas have failed to gain traction in the past but supporters hope to better their chances this year by hitching them to President Obama's top domestic priority, which has passed in the House of Representatives and is being debated in the Senate. "This is the kitchen sink train leaving the station," said Neil Trautwein of the National Retail Federation. "Every idea, good, bad or otherwise, that has ever been out there has to find its way in."

• Companies with 50 or more employees would have to set aside "reasonable" break times for nursing mothers and create a private space for breastfeeding. "There's no question that this is a smart health care practice," said Sen. Jeff Merkley, D-Ore., who fought for the provision. Trautwein said the idea smacks of "too much Uncle Sam."

• Nurse midwives would be paid the same as doctors for their services under Medicare. They now receive about 35% less. Midwives perform maternity care for about 3 million disabled women who qualify for Medicare, according to the American College of Nurse-Midwives, and also provide primary care, particularly in rural areas.

• Restaurants with more than 20 locations would be required to post nutritional information.

"People are eating out more and more," said Rep. Jim Matheson, D-Utah, who supports the proposal. "If you give consumers more information, they can make more informed decisions."

Included in the provision is a requirement that vending machines must include nutrition labels consumers can see before they plug in their change for candy or a bag of potato chips.

Four states — California, Maine, Massachusetts and Oregon — have passed laws requiring chain restaurants to post calorie content, according to the National Conference of State Legislatures. But none of those laws have tackled vending machine labels.

"I wouldn't eat any of it," Sen. Thomas Carper, D-Del., who supports the measure, said of vending machine fare — though he admits to being tempted on occasion. "But others will. I just want to ensure they have a better idea of what they're getting."

Ned Monroe, a lobbyist with the National Automatic Merchandising Association, said the changes could cost $56 million in labels and staff time. "That kind of an impact when our industry is already suffering is going to cost jobs," he said.

Thomas Martin, a 53-year-old diabetic, said the labeling would help him think twice before buying. "It'd be nice," he said as he pulled an ice cream sandwich out of a vending machine in Maryland.

The Senate's version of the health care legislation would cost $848 billion in the first 10 years. It would require all Americans to buy a health policy and would expand Medicaid.

Merkley said the breastfeeding provision, which has failed in the past, stands a better chance now as part of the massive revamp of health care. "The best odds of passing anything relative to health care," he said, "is to put it in a bill that's going to be debated and voted on."

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